Individual provider Active NPI

Larissa Caputo

  • Certified Registered Nurse Anesthetist
  • Fort Walton Beach, FL
National Provider Identifier
1730632308
Registry record updated Feb 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN9344203 Issued in FL
Practice address
1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708
Phone
(850) 862-1111
NPI assigned
Jul 29, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN9344203 FL Primary

Addresses

Primary practice location

1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708

Mailing address

1860 Seahawk LN
Navarre, FL 32566-8530
Phone (727) 470-7950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170328002335 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0143505487 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ams of Gulf Breeze LLCGroup PAC ID 9537326665, 38 clinicians
Ams Baptist LLCGroup PAC ID 6901099688, 80 clinicians

Practice addresses (Care Compare)

1110 Gulf Breeze Pkwy
Gulf Breeze, FL 32561-4884
Phone (850) 934-2000

123 Baptist Way
Pensacola, FL 32503-2254
Phone (448) 227-8478

Hospital & facility affiliations

  • Baptist Hospital Hospital, Pensacola, FL, CCN 100093

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN9344203FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Ams of Gulf Breeze LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 26, 2017 Accepting new patients
Sheridan Healthcorp, Inc. CurrentSince Jan 4, 2017 Accepting new patients
Ams Baptist LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 26, 2017 Accepting new patients
Sheridan Healthcorp, Inc. Nurse Anesthetist, Certified Registered CurrentSince Jan 4, 2017 Accepting new patients
Sheridan Healthcorp Inc Nurse Anesthetist, Certified Registered Current Accepting new patients

Locations

1000 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 374-9610

4600 SW 46th Ct
Ocala, FL 34474
Phone (352) 291-3000

123 Baptist Way
Pensacola, FL 32503
Phone (850) 434-4011

1110 Gulf Breeze Pkwy
Pensacola Beach, FL 32561
Phone (850) 438-1848

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1469750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487548800000",
    "number": "1730632308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 SEAHAWK LN",
            "city": "NAVARRE",
            "state": "FL",
            "postal_code": "325668530",
            "telephone_number": "727-470-7950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476708",
            "telephone_number": "850-862-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPUTO",
        "first_name": "LARISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-29",
        "last_updated": "2017-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "RN9344203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.